Myrtle Street Obstetrics and Gynecology, PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

189300-1 Issued in NY

Legal business name

MYRTLE STREET OBSTETRICS AND GYNECOLOGY, PC

Practice address

2105 Ellsworth Blvd
Malta, NY 12020

Phone

(518) 587-2400

Fax

(518) 581-0141

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Louise West

Title

Practice Administrator

Phone

(518) 587-5304

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1629344320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 MYRTLE ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661093",
            "telephone_number": "518-587-2400",
            "fax_number": "518-581-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 ELLSWORTH BLVD",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-587-2400",
            "fax_number": "518-581-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE STREET OBSTETRICS AND GYNECOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "518-587-5304",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "189300-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Morgia, RN
• Amanda Morse
• Deborah Davis Mulligan-Timer, FNP-BC, PMHNP-BC
• Marianne A Mustafa, M.D.
• Tammy Myers, LMHC, CASAC
• Candy Nalewajek
• Keir Neighmond, DO
• Newstone Mobile Imaging LLC
• Megan Nieckarz
• Mark Nistico, RN

• Obstetrics & Gynecology Physician in Malta, NY
• Providers in Malta, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.